Safety and anatomical outcome analysis after flow diverter coverage of the anterior cerebral artery.

• The main objective of the article was to study the safety on the anterior cerebral artery after FD coverage of the A1 artery. • The study results indicate that covering the A1 artery did not significantly affect blood flow in the perfused area of the anterior cerebral artery. Perfusion was ensured through side branch compensation and abundant anastomotic branches. • All ischemic complications were observed in the study occurred in the perioperative period and could be ameliorated by conservative treatment or interventional procedures, and patients had a good prognosis. • Risk of ischemic complications related to the anterior cerebral artery even if the anterior communicating artery is open after FD placement. Few studies on ischemic complications and flow changes after a flow diverter covering the anterior cerebral artery. The purpose of the study was to explore the ischemic complications and anatomical alterations associated with the flow diverter after it covers the anterior cerebral artery. In this single-center study, patients treated with FD covering the anterior cerebral artery at the First Affiliated Hospital of Zhengzhou University were retrospectively collected. The primary endpoint was ischemic complications related to the anterior cerebral artery. Secondary endpoints were anatomical changes in the anterior cerebral artery postoperatively and at follow-up. A total of 59 patients were included in this study. Four (6.8%) patients presented with ischemic stroke symptoms. Immediately after the procedure, complete occlusion of A1 and decreased blood flow was observed in 13 (22.0%) and 21 patients (35.6%), respectively. At follow-up, A1 artery was occluded in 34 patients (57.6%) and decreased blood flow was observed in 10 patients (16.9%). Symptoms of neurological deficits related to the anterior cerebral artery were not observed in all patients at follow-up. Coverage of A1 is safe, with a low incidence of ischemic stroke, when using an FD to treat aneurysms. Risk of reduced perfusion of the anterior cerebral artery postoperatively even if the anterior communicating artery is open. In cases with A1 occlusion, the blood flow in the distal the anterior cerebral artery can be adequately compensated by opening the anterior communicating artery and good vascular anastomoses. [ABSTRACT FROM AUTHOR]